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What is Rumination Disorder?
Written by Medicover Team and Medically Reviewed by Dr Siva Anoop Yella , Psychiatrist
Rumination disorder is a rare eating disorder where a person repeatedly brings up food from the stomach to the mouth soon after eating, effortlessly and without gagging or nausea. This regurgitated food may be rechewed, swallowed, or spit out. The behavior is not related to acid reflux or vomiting and often becomes a habitual response.
Also known as merycism, this condition is most commonly seen in infants, children, or individuals with developmental delays, though it can also affect teens and adults.
Over time, rumination disorder can lead to weight loss, nutritional deficiencies, and emotional distress, especially in social situations. With early diagnosis and behavioral therapy, most individuals can recover and develop healthier eating habits.
Who Gets Rumination Disorder?
Rumination disorder can affect people of all ages, but it is more common in certain groups.
- Infants and Young Children
- Children with Developmental Delays
- Teens and Adults
- People with Eating or Anxiety Disorders
With the right care, most people can recover and return to healthy eating.
What are the Symptoms of Rumination Disorder?
Symptoms of rumination disorder often appear shortly after eating and can be mistaken for other gastrointestinal issues. However, the behavior is distinct and typically repetitive. Below mentioned are the possible signs of rumination disorder:
Common Symptoms
- Repeated regurgitation of food within minutes of eating, usually effortless
- Rechewing or swallowing food or spitting it out
- No signs of nausea, gagging, or involuntary vomiting
- Weight loss or poor weight gain (especially in children)
- Bad breath and dental erosion
- Stomach pain or discomfort due to frequent regurgitation
- Avoidance of eating in public or social embarrassment
These symptoms may be conscious or unconscious and often occur on a daily basis. Early evaluation is essential to prevent long-term complications and to rule out other eating disorders or medical conditions.
What are the Causes of Rumination Disorder?
The aetiology of Rumination Disorder is not fully understood; however, several factors contribute to its development. It's essential to recognize that Rumination Disorder is not a conscious decision but a complex interplay of psychological and physiological factors.
Psychological Factors
Psychological elements are often at the core of Rumination Disorder. These can include:
- Stress and anxiety: High-stress levels may trigger the onset of the disorder as a coping mechanism.
- Emotional trauma: Previous traumatic experiences can manifest as eating disorders, including rumination.
- Poor coping mechanisms: Individuals may use regurgitation as a means to deal with emotional distress.
Physiological Factors
Certain physiological aspects may predispose an individual to Rumination Disorder:
- Abnormalities in the digestive tract: While not a direct cause, digestive issues can coexist and exacerbate symptoms.
- Muscular control issues: Dysfunction in the muscles responsible for swallowing may lead to regurgitation.
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Get Second OpinionWhat are the Risk Factors for Rumination Disorder?
Certain factors may increase the likelihood of developing rumination disorder, especially in early childhood or in individuals with developmental or emotional challenges.
- Age and Development
- Developmental Delays or Disabilities
- Emotional or Psychological Stress
- Unstimulating or Neglectful Environments
- History of Gastrointestinal Disorders
- Coexisting Eating Disorders
Recognising these risk factors early can lead to better outcomes through timely behavioural intervention and supportive care.
How is Rumination Disorder Diagnosed?
Diagnosing rumination disorder involves a careful clinical assessment to rule out other medical and gastrointestinal conditions. There is no single test for it, so doctors rely on a combination of observation, history, and sometimes specialized tests.
Key Steps in Diagnosis
- Medical History & Symptom Review: The doctor will ask about eating habits, regurgitation patterns, and emotional or developmental background.
- Physical Examination: To check for signs of malnutrition, dehydration, or dental erosion.
- Behavioural Observation: In children, especially, doctors may observe feeding sessions to identify repeated regurgitation.
- Rule Out Other Conditions: Tests may be done to exclude gastroesophageal reflux disease, gastroparesis, or eating disorders like bulimia.
- Psychological Evaluation: This may be included to assess for anxiety, trauma, or developmental disorders.
Early diagnosis is crucial for preventing nutritional deficiencies and social or emotional complications.
What are the Treatment Options for Rumination Disorder?
Rumination disorder can be treated successfully, especially when diagnosed early. The primary goal of rumination disorder treatment is to break the regurgitation habit and promote healthy eating and emotional well-being.
- Behavioural Therapy:
- Deep belly breathing: This technique teaches the person to engage the muscles that help prevent regurgitation.
- Habit training: Helps them notice when it’s about to happen and respond differently.
- Rewards and praise: Used with children to encourage healthy eating habits.
- Nutrition Support:
- Healthy meal planning to improve nutrition and weight.
- Close monitoring of growth in children or teens.
- Counselling and Emotional Support:
- Talk therapy (CBT) helps manage stress, anxiety, or trauma.
- Family therapy helps parents support their child's recovery.
- Treatment of Other Health Issues:
- If needed, doctors treat reflux or stomach problems.
- In rare cases, medicines may help with anxiety.
- Exceptional Support for Developmental Delays: For people with autism or intellectual disabilities, care includes structured routines, behavioural coaching, and ongoing support.
With the proper treatment and support, most people recover well from rumination disorder.
When to See a Doctor for Rumination Disorder?
It's essential to seek medical help if you or your child exhibits signs of repeated regurgitation after meals, particularly if it's impacting nutrition, growth, or daily life. Early diagnosis leads to better outcomes.
See a doctor if
- Regurgitation happens regularly after eating, without signs of nausea or illness
- There is unexplained weight loss or poor weight gain
- Bad breath, tooth damage, or frequent stomach pain is noticed
- Your child avoids eating or becomes anxious during meals
- Symptoms affect school, social life, or emotional well-being
A timely medical evaluation can help rule out other conditions and initiate the appropriate behavioural or nutritional treatment early.
Your health is everything - prioritize your well-being today.
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Long-Term Management and Prognosis of Rumination Disorder
With early diagnosis and proper treatment, the long-term outlook for rumination disorder is generally positive, especially in children and adolescents. However, continued care is essential to ensure lasting recovery and prevent relapse.
Long-Term Management
- Ongoing Behavioral Support: Continued use of diaphragmatic breathing and habit-reversal strategies helps maintain progress, especially during meals.
- Regular Follow-Ups: Scheduled check-ins with healthcare providers help monitor nutrition, weight, and emotional well-being.
- Nutritional Monitoring: Dietitians may help guide eating habits to ensure balanced nutrition and healthy growth in children.
- Psychological Care: Some individuals may benefit from extended therapy to address coexisting anxiety, trauma, or emotional distress.
- Parental or Caregiver Involvement: Family education and support are crucial in reinforcing behaviour strategies at home.
Prognosis
- In Infants and children, most individuals recover fully with early behavioral intervention and do not experience lasting problems.
- In Adolescents and Adults, Recovery is also likely, though it may take longer if the disorder is linked to emotional stress or other mental health issues.
- For individuals with developmental disorders, progress may be slower, but long-term improvement is still achievable with consistent, supportive care.
With the proper treatment and family involvement, most individuals can overcome rumination disorder and lead healthy, everyday lives.
Our Experience Treating Rumination Disorder
At Medicover Hospitals, we care deeply about helping children and adults with rumination disorders. Our team comprises doctors, therapists, psychiatrists, and dietitians who collaborate to provide each patient with the most suitable care.
We start by learning about your symptoms and daily habits. Then, we use simple and proven methods, such as deep belly breathing and mealtime support, to help stop regurgitation. We also guide families on how to support their loved ones at home.
With early help and kind, personalised care, most of our patients experience significant improvement and go on to eat, grow, and live with confidence.
